If you're going to base your diet on the bible, then you shouldn't be eating pork (Leviticus 11:7), and you should eat plenty of locusts and crickets (Leviticus 11:22)

Oooh, wait'll the God-deniers get a load of this one.

Actually, I've wondered about the proper interpretation of passages like those mentioned, and this post is helpful for me.

I appreciate this & putting the verses into context - but was human excrement to be used as content in the bread, or the fuel source to bake it?

I'm pretty sure the dung was not to go into the bread, it was to be used as fuel for the fire over which the bread was baked. But your point still holds very well. They also omit the lying on your side for 390 days. If eating Ezekiel bread is so healthy, so must be lying on your side for over a year.

I prefer to "kill the fattened calf."

LOL

Dung was probably not an ingredient, but the fuel used to cook the bread.  (Still pretty unsavory, though.)

1) All religion is poetry...

-- Paul Tillich

2) I have a huntch that, uh, folks from a couple thousand years ago, uh, never heard of macronutrients, glucose, insulin, etc.

3) Peace

For those who are interested in the Bible's statements on food, here's a link to a brief overview of kosher laws:

http://www.kashrut.com/articles/soul_food/

Combining a lesson in both religion and medicine, Love It!!

I agree with you, Dr. Davis, that religious issues are very important to many people concerned about dieting. And it is important to discuss them, even though some people think that religious issues should not be part of any discussion related to diet.

In fact, a lot of people who think  about diet issues from a scientific standpoint tend to think that religiosity is a product of pure stupidity. This post and the comments in response to it illustrate what I am talking about:

http://healthcorrelator.blogspot.com/2010/05/atheism-is-recent-neolithic-invention.html

Waiting for my local library to get a copy of Pandora's Seed by Spencer Wells. In it, he examines the unforeseen costs of farming, which began to transform society 10,000 years ago (using a scientific timescale), such as diabetes and obesity.

Definitely one of man's worst inventions.

Interesting fact:  The Catholic church will not use anything other than wheat to make the wafers for the Eucharist.  If you have wheat intolerance, you can request a low-gluten wafer.  But a non-wheat wafer will never be used as part of that sacrament, no matter how badly one might react to wheat.

I think that stance is a bit much, but I am not a devout Catholic.

Dr. D.
As the Brits say; you are on a losing wicket.

No person of religion will be pursued to move from the crowd. That is why they follow.

Great post! I've never understood how people can take the Bible literally. As someone mentioned in the comments, it's mainly poetry, and it describes a frame of reference and customs of thousands of years ago. Would be very weird to apply all that literally to our high-tech society.

I looked the Bible fragment up in Dutch. It says he has to bake it on human dung (i.e. using the dung as fuel). The fun thing is that a couple of verses later Ezechiel complains and says he has never eaten anything impure in his life and then God gives in and says, 'OK then, you can use cattle dung instead of human dung.'

Sounds to me like the beginning work on "fecal transplant".

But, here's the question: do you think the Ezekiel Bread is worth eating for health reasons?

Other translations have the dung as a source of fuel.  
As much fat as I eat, you'd probably have to put a wick in it.
I don't think that would give it a nice smoke flavor or anything.

I think some of these comments are missing the point. Whether the dung was used as fuel or incorporated into the recipe makes little difference to the interpretive thrust of the passage. According to Mosaic ceremonial law (which was typological, not perpetual), excrement was to be covered with dirt. You don't touch it, and you certainly don't cook with it. The point is that the bread was polluted, and this served as a typological symbol of Israel's pollution and rejection. Israel, the elect and "clean" nation, has become filthy.

God didn't make Ezekiel write this stuff down so we could whip up a great recipe 2400 years later. And by the way, the same goes for the book of Daniel. Just because Daniel and his buddies ate nothing but vegetables and water for ten days doesn't mean that vegetarianism is the best diet. That's not even close to the original intent of the passage. Yet I see these kinds of non-contextual claims all the time. It saddens me when I see fellow Christians using the Bible this way.

FYI: The "Wheat and the Bible" article can be accessed in its entirety on my website here: http://www.reforminghealth.com/Wheat_and_the_Bible.pdf

David

Thanks, David.

For anyone else interested, David's article provides a very nice overview of the broader topic of Wheat and the Bible.

Dr. Davis, I appreciate your courage in tackling this difficult subject. Dr. Kurt Harris has also discussed the fact that even traditional methods of processing wheat do not eliminate all of its negative qualities: http://www.paleonu.com/panu-weblog/2009/12/28/avoid-poison-or-neutralize-it.html.

Religious concerns are undoubtedly one of the trickiest issues that biologically appropriate diets raise. Everyone on the planet is not going to abandon what they see as their religion principles for health reasons, so I try to meet people where they're at. For those Christians who tell me that wheat must be healthy because it's in the New Testament and the Levitical diet, I say, sure, the Levitical diet is older and healthier than the SAD of today, but there was an even earlier diet in the Bible that's even healthier. It's composed of God-made foods instead of man-made foods. It usually occurs to them that this is the diet of wild foods available at the time of humanity's creation, which I also refer to as the "Garden of Eden diet", which was free of wheat bread, even unleavened, and certainly wouldn't contain any pizza, pasta or processed breakfast cereal. This doesn't always convince people, but it rarely fails to give them pause.

Plus, in Genesis 3:17-19, bread is part of a curse, not a blessing. So wheat could be regarded as a blessing compared to starvation, but a curse or penance compared to the original Biblical foods of the Creator's making.

Also, at times in the Bible, suffering is treated as an opportunity for penance or purification. It doesn't mean the bad stuff that causes the suffering (ie wheat) is "good" in and of itself. Perhaps this could be a way to explain Jesus' direction to eat bread in remembrance of Him? I generally avoid this subject as potentially too touchy, so I'm curious for input from wheat-avoiding Christians on how they deal with this.

On top of all the above, bread is no longer necessary for survival in wealthy modern cultures, like it may have been in some of the regions and times covered by the Bible. So the contexts are very different.

Hope this helps.

Paleo Phil,

As a wheat-avoiding Christian, I deal with this issue by actually trying to return the focus to the intent of the Biblical text(s). Was it the biblical author's intent to communicate wheat/grain as perpetually appropriate and required foods for all time (unlikely), or was it rather simply that the biblical narrative existed within an agricultural context and was thus accommodated to those times? I think the latter option is the reasonable one.

In the biblical account, all of creation is said to be "good" (as opposed to Gnosticism, which says that matter is intrinsically evil) but I think it is a mistake to take this as synonymous with "harmless," and it is important to remember that despite being "good," elements within creation can be either appropriate or inappropriate depending on the use and context. Plant toxins are "good" in the creational sense in that they make for a balanced and workable ecosystem, but are relatively "bad" for the unwary animal that eats them. The wheat/grain issue is no different. Grains might be creationally good and play an important role somewhere in the broader order of things, but this doesn't mean they're harmless if the circumstances are right (e.g. genetic modification, improper preparation methods, etc., etc.).

Appealing to the "Garden of Eden diet" might work for some Christians, but I think there's a deeper problem going on. Too many modern Christians see the Bible as a sort of "prescription" for what they should or should not eat. For instance, the Levitical diet (clean vs unclean foods) is often pointed to as the ultimate "healthy diet." However, the health aspects had nothing to do with the actual declared purpose of the restrictions. The diet was purely typological and temporary, and any health benefits were merely coincidental side-benefits. These typological requirements have had an antitypical fulfillment, however, so the diet should have no bearing on anyone today.

Likewise, many Christians point to the supposedly vegetarian diet in Genesis as the "original" diet that mankind was created for. But again, this misses the point of the author's literary intent. What was going on in the Genesis creation account? Was Moses telling us how to eat, or was he telling us something completely different? Most Christians are clueless here. As it turns out, the creation story has nothing to do with scientific explanations or dietary prescriptions. It was written in an ancient Near Eastern (ANE) context where creation myths abounded, and Moses was contrasting the Hebrew God with the surrounding deities of the ancient world. The account is not relating scientific facts, but is rather a literary polemic written to combat other ANE pagan religions point for point. The God of Israel is not like Ptah, or Shu, or Marduk, or Baal. The Genesis account powerfully overturns the Enuma Elish and other ANE creation stories. That was its historical intent.

Unless one is familiar with ANE culture, many of the subtleties within the Genesis account will not make sense, and you will end up with an interpretive disaster, like Young-Earth Creationism or Vegetarianism, for instance. The Bible does say that God created, but it does not tell us how He created. This is nowhere near the intent of the original author.

(Continued)

As I read the chapter, it looks more like Ezekiel is instructed to act in a symbolic manner.  He is instructed to symbolically lay seige to a model of Jerusalem that is drawn or built on a tile--even building miniature seige engines. In essence, the call to moral behavior in the book is a "seige" against the transgressions done within the city.  Thus, the "bread" is also to be made and eaten as a symbol.  The context is fairly plain.  Nowhere is there any statement that Israel, or even just Jerusalem, is to make or eat the stuff.  Ezekiel is told to bake and eat the bread "in their sight" or "in the sight of the people" and then tell anyone who sees him that this is the level of wretchedness they will be reduced to, I presume because of their faithlessness and obstinacy after many warnings, given the general context of the Book of Ezekiel.

Thus, "Ezekiel bread" is actually a symbol of the wrath of God against the obstinately faithless and not a "recipe" for what God wants a faithful believer to eat daily.

What does vitamin D have to do with the improved heart valve?

Maybe a little vitamin k with the vitamin d would give even better results for aortic valve disease.

If this is true, I can only speculate on the mechanism for vitamin D's effect. It might include anti-inflammatory effects, suppression or modification of calcium deposition, and lipid (cholesterol) effects. However, this is just my speculation.

I also agree that adding vitamin K2 may exert an effect, particularly in view of the valve disease that develops when people take the vitamin K blocker, Coumadin.

Why do you stress Vitamin D3 supplements be in gel cap form?  Many of these contain Vitamin A in addition to the D.  If capsules of D are taken after a meal containing some fat, woulden't that suffce?

If you want consistent absorption of vitamin D, gelcaps are best. Tablets are, in my view, next to worthless because of the erratic absorption, even when taken with a fatty meal.

You can find D without A. Go to Vitamin Shoppe or buy Carlsons'brand.

Dr. Davis, I think you neglected to mention vitamin D in your blog article. Take a look at what you wrote!

Whoops!

Yes. It was vitamin D supplementation that I presume was the factor behind the effect on valve disease.

Dr. Davis,

Thanks for the thoughts. And, I really like your blog.  Thanks for sharing. I'm definitely coming back!

Cheers,

Adam
Adam's Heart Valve Surgery Blog

Any suggestions on dosage requirements of D3 gel caps?

We've used anywhere from 4000-8000 units per day of an oil-based gelcap to achieve this effect.
Please see my numerous prior posts on vit D dosing, along with commentary on our website, www.trackyourplaque.com.

I'm 60 and just this week was diagnosed by echo as having a bicuspid aortic valve that is clacified, sclerosed and fused with a valve area of 1.1cm.  I'm asymptomatic, but my reading shows I'm headed for valve replacement within a few years at most.  I read you anecdotal reports of vitmain D apparent reversal of aortic stenosis.  However, I am aware that vitamin D can increase calcium deposition in tissues.  Are you sure this is safe for patients like me?  You are aware that nothing to date has been proven to change the natural history of this disease, so I find your blog posts to be provocative at best and perhaps rather reckless despite your medical credentials.  Do you have any recent follow-up on your initial anecdotal report?

Hell of a way to ask for help, Bill!

Being as I see no further follow-up on this one patient back in 2007, I'll just add that I had my vitamin D levels checked in September and they were low, so I decided to try Dr. Davis's idea.  On 10K IU of D3 I achieved normal vitmain D levels.  Unfortunately, in the last 6 months my AS has progressed with my valve opening going down from 1.1 to 0.9cm.  I still am asymptomatic but will have another echo in 4 months.  My cardiologist is concerned as my left ventricle also increased in size from 5.6 to 6.8cm in 6 months. I'll give the D3 another 4 months, but so far, it appears not to be helping at best and perhaps is accelerating the progression of my AS.

Further follow-up on my case.  Today I just got back from Stanford where I had another echo and met with Dr. Craig Miller, Chief of Cardiothoracic Surgery, to discuss my options.  My valve has further stenosed down to 0.7cm from 0.9 only 3 months earlier.  So, despite healthy doses of vitamin D, it looks like, if anything, the calcification of my valve has accelerated. This really points out how a single anecdotal report can be rather misleading.  Although I can believe that the patient's AS in the original report may have receded, there is no way you can attribute this to vitamin D.  It could be a completely unrepeatable coincidence.  Dr, Davis, with all due respect for your good intentions and the benefit you may otherwise provide to your patients, you really ought to remove your case report until you have some more concrete, repeateable evidence.  It not only may not have helped me, but it may have harmed me.

William--

Sorry to hear about your valve "progression."

My experience is not one patient, but around 20. Most have shown either modest reversal of aortic valve stenosis or stabilization (i.e., no change); two have progressed.

So your experience is the exception, not the rule, compared to what I am seeing. I cannot claim that vitamin D is the "cure all," but I believe this phenomenon can teach us some interesting lessons.

By the way, your disease, I believe is just showing the natural progression. Small leaps in severity like this are not uncommon in the absence of vitamin D.

There are some people who's bodies are predisposed to use vitamin d the wrong way. Here's a link to one page that can take you to the research on this subject.
http://www.examiner.com/x-7160-Sacramento-Nutrition-Examiner~y2009m4d15-Will-taking-vitaminD3-calcify-your-aorta-if-you-have-a-certain-genetic-variation

Dr. Davis,
Following the previous post from 'anonymous' I would add this comment in support of Bills thoughts that your posts may be 'reckless'.

There is some evidence that vitamin D can actually CAUSE aortic valve calcification, both in animal models (see The Journal of the American College of Cardiology 2003, Volume 41, Issue 7, Pages 1211-1217: Experimental aortic valve stenosis in rabbits) and in human patients (see Heart 2001, Volume 85, pages 635-638: The vitamin D receptor genotype predisposes to the development of calcific aortic valve stenosis). In this case, you should be very careful in extrapolating your observations of one patient (perhaps with unusually low LDL) to a blanket 'vitamin D restoration' model. It could cause deterioration in the health status of those who seek your expertise without a proper diagnosis.
A good PubMed search will provide the necessary literature for you to research (rather than speculate) on the mechanism for vitamin D's effect, and may help you to follow the ongoing debate about the validity of the animal model.

Anon--

I believe you are confusing two things: vitamin D at physiologic replacement levels (as we do in humans) and vitamin D at toxic, supraphysiologic levels (as in rats and mice).

Like any hormone, too little is not good, too much is not good. We want just right to obtain the benefits.

Hi again Dr. Williams,

forgive me for pushing you on this, but I am not confusing two things at all.

One should, of course, always be cautious when extrapolating animal studies to humans and, while the supraphysiological (toxic) levels shown in some animal models is a potential issue (though also debatable, as physiological - or nutritionally relevant - levels CAN induce valve stenosis in mice with sub-optimal lipid metabolism), the main issue is that we are beginning to understand the complexity and potential danger of untested 'nutritional supplements' because of the wide genetic variation that exists in any population (see the second reference I provided for you comparing 630 HUMAN patients). Further, there is very little data on what actually represents 'toxic' levels in humans who take complex multivitamin mixtures, regardless of geographic considerations, environmental load and preexisting baseline blood concentrations (e.g., would you advise selenium supplementation for someone living in Nebraska?).

This is perhaps demonstrated by your own reports of "around 20" patients (the complete statistics for which I would be interested to see). What is meant by "modest reversal or stabilization in most"? Is not the "around" 10% who have regressed worthy of your interest? I would have thought that without a recovery in all of your patients, you may consider that you are indeed "getting your hopes up prematurely" and that you may be more keen to understand the biochemistry behind the failures. Perhaps you could secure funding to follow these patients in a well designed scientific study? There must be other doctors with similar experiences who would be keen to push the science forward and take it out of the realm of anecdote?

While I absolutely agree with you that prevention is better than intervention (I saw an excellent seminar just yesterday from professor Richard Cooper [from Loyola Chicago] demonstrating how just reducing salt intake can have dramatic effects on heart health in most people, and Professor Valentin Fuster [Mount Sinai] knows how a good exercise regime can reverse coronary desease). And while I also don't like the 'statin-and-stent' mentality (do statins work at all in women??), I also believe that drug disposition and pharmacokinetics are incredibly important.

I simply think that you should place an enormous caveat on any of your posts that suggest that supplements such as vitamin D (and perhaps K, A, E, C, selenium etc. etc.) might be a 'magic bullet'. None of them is when applied across the board. In fact, there is strong, reputable and repeatable science that demonstrates potential damage caused by some of these unregulated concoctions that are marketed as 'healthy' (the topic of another of your 'scam' posts when applied to health foods).

You are absolutely correct that the vitamin D phenomenon "can teach us some interesting lessons", but you are not the first person to have noted this idea and it is being investigated in fairly comprehensive studies. When the results are in, perhaps we will have a better understanding of the types of patient for whom it would work (and those for whom it may be dangerous).

As with other eminent 'web-doctors' (e.g., Dr. Mercola, who advises vitamin D instead of the flu vaccine, or those who push "vitamin B17" instead of cancer chemotherapy), I would suggest that a blog is not a good place to practice science or medicine and I would hope you would regularly advise your readers to go to a good doctor in their area who perhaps agrees with your alternative methodologies for a full and well considered diagnosis.

Thank you, Anonymous.

First of all, it's Dr. Davis, not Williams.

Second of all, I agree with one of your points: This is the Heart Scan BLOG, not the Heart Scan Journal, not the Heart Scan List of Facts. It is a BLOG--pure and simple.  

I hope anyone coming here for my musings and thoughts realize that's all they are. If anyone is stupid enough to make more of it than that, well that's not my problem.

Hi Dr. Davis (apologies for the previous mistake),

I wanted to point out that I enjoy your Blog and I share your interest in a nutritional basis for the prevention of cardiovascular disease. However, you allude in your various blogs to several of the unanswered issues behind our understanding of a highly complex topic. Salt reduction, resveratrol, caloric restriction and the enormous array of vitamins provide clear benefits for some people and yet seem to have almost no effect (or, when combined carelessly, even a detrimental effect) on others.

Based on your last response, I have a final comment on this "more on aortic valve disease and vitamin D" post on your 'blog - not advice'. Then you can choose to be incensed by it, or take it as it is meant - a comment from a concerned cardiovascular research scientist who would dearly like to see these alternative approaches brought into the mainstream.

Whether you accept responsibility for it or not, it is clear that some people read your postings and act on your "musings". You are, after all, a cardiologist and seen as an expert in medical matters. Further, you and I both know that the vast majority of people neither have access to nor the potential to understand the scientific literature, so the internet has become a frequently dangerous tool by which millions get their information and advice.

In this thread alone, there are people asking for (and receiving) specific advice on the type of vitamin D to acquire (gel caps) and the purported optimum dosage (anywhere from 4000-8000 units per day). Further, while you don't actually tell him to, William Ball was clearly following what he perceives as 'Doctor's advice' when he "decided to try Dr. Davis's idea".

His subsequent decline was then 'diagnosed' by you as likely being a "natural progression", even though he states that his vitamin D levels were "normal". This was apparently after taking 10,000 IU per day? Perhaps Mr. Ball would have been interested to know that 10,000 IU is the figure proposed by Hathcock et al., in 2007 as being the upper tolerance limit for humans [Am. J. Clin. Nutr. 85 (1): 6–18] - and should perhaps raise alarm bells.

There were several opportunities for you to make more clear that this is just "a blog" and should not be used as an alternative for sound medical advice. There is a lot still unknown about this topic and while "not your problem" (and to use your words) there are plenty of people "stupid enough to make more of" your post that you might wish.

I have several friends for whom I have great concerns because they follow potentially dangerous alternative health approaches based on the "knowledge" they glean from the internet. One friend takes potentially toxic doses of the cyanide compound 'vitamin' B17 to prevent cancer. I have family members who have not vaccinated their children because they KNOW vaccines cause autism. Another refuses to use toothpaste and spends a fortune on bottled water because fluoride will reduce his IQ and give him cancer.

Big Pharma is now seen almost universally as demonic and conspiracy theories abound. According to such theories, without the influence of doctors, scientists and pharmaceutical companies, we would already be living in a world without cancer and cardiovascular disease - but we are hiding the answers for the sake of profit. While you clearly hold some cynical views about the profitability of the 'conventional treatment' of heart disease, most doctors are doing the best they can under hugely difficult circumstances (and in the face of patients refusing to change bad behavior). We can only hope that the future is brighter as a result of the research being conducted on the alternative preventive measures to which you subscribe.

In the meantime, as a doctor, you should perhaps be more aware of your influence and how blindly some people will follow your advice, whether you think you have given it or otherwise.

Aortic valve stenosis is generally regarded as a progressive disease that must eventually be corrected with surgery--period. The only other strategy that has proven to be of any benefit is Crestor 40 mg per day, an intolerable dose in my experience.